Tanzania: Cholera Outbreak - Emergency Plan of Action (EPoA), DREF n° MDRTZ031


A. Situation analysis

Description of the disaster

On 23 April 2022, the government reported cholera cases in Uvinza DC (Kigoma region) and Tanganyika DC (Katavi region). These cases were reported in the Kalya ward in Uvinza DC which has a population of 22,486 (Kigoma region) and Karema and Ikola wards with a population of 15,982) Tanganyika district, Katavi region).

By 28 April 2022, the outbreak had spread to other areas along the lake shores of Lake Tanganyika with a total of 129 symptomatically suspected cases of which eight were confirmed. Uvinza district accounts for the majority of the cases (106 cases) distributed in the following district: Kalya village 3, Sibwesa village 47, Kashangulu village 56 While in Tanganyika district 23 accounts for 13 cases from Ikola, 1 Mchangani, and 9 Karema. Most of the affected locations are fishing villages with poor sanitation practices that include open defecation and densely populated areas which lack adequate sanitation with poor access to clean and safe water, posing a danger for further spread of the epidemic. Zero fatalities have been reported to date. See the summary of cases distributed per Cholera Treatment Centre (CTC) in Table 1 below:

This cholera outbreak has occurred during the rainy season, and it bears a high potential to spread to other hotspots within Kigoma and Katavi if not well managed. Kigoma also is hosting refugees and if not controlled, the cases might spread there. The outbreak may have originated from the Rukwa region nearby, where cases were reported in early March 2022. The initially observed trend of cholera puts the villages along Lake Tanganyika at high risk of transmission, and if not contained, then cholera might eventually spread to other parts of the country. Currently, there are no reports of suspected cases in the rest of the country, and the Ministry of Health (MoH) is tracking all reported cases of acute watery diarrhoea and symptoms of cholera through an active surveillance system.

A risk assessment is being conducted by the Ministry of Health. Once the assessment report is shared with partners, it will give more clarity regarding the situation and gaps in the response strategy. Meanwhile, the MoH has put in place systems for the response. Regional and district multi-sectoral response plans are being completed; these will be shared with relevant stakeholders after approval.

Tanzania still faces challenges to attain universal access to safe and clean drinking water, along with inadequate sanitation, particularly in unplanned settlements along the lake shores and densely populated settlements in urban settings. According to UNICEF, 61% of the population uses at least basic drinking water services; and 26% use safely managed sanitation services (Source: https://data.unicef.org/country/tza/).

It is notable that, while Cholera is endemic in Tanzania, the country has not had an outbreak since 2019, mostly attributable to multiple cholera preventive interventions being implemented within the context of the country’s COVID19 prevention Plan.

Meanwhile, the Government is currently responding by addressing gaps in the main pillars that include Risk Communication and Community Engagement (RCCE) and WASH. TRCS Health promotion unit has been contacted to support awareness creation through the distribution of IEC materials, house-to-house visits, and public address (PA) systems to ensure that members understand the risk of cholera spread among the community and to encourage the adoption of prevention and control measures. The Rural Water Supply and Sanitation Agency (RUWASA) is currently sourcing out to increase access to clean and safer drinking water. RUWASA also continues to implement chlorination of water although might be insufficient for long-term periods. Additionally, the CHW and TRCS volunteers are demonstrating how to treat water, and mapping households’ sanitation in the affected areas to advocate for constructing improved latrines.